Abstract
Objectives
To examine the bidirectional temporal relationship between depressive symptoms and
cognition in relation to risk, reaction, and prodrome.
Design
Cross-lag analysis of longitudinal data collected online at baseline and 12-month
follow-up.
Setting and Participants
A United Kingdom population cohort of 11,855 participants aged 50 years and over.
Measures
Patient Health Questionnaire-9 (depressive symptoms), cognitive measures: Paired Associate
Learning, Verbal Reasoning, Spatial Working Memory, and Digit Span.
Results
Depressive symptoms predicted a decline in paired associates learning [β = −.020, P = .013, (95% confidence interval [CI], ‒.036, −.004)] and verbal reasoning [β = −.014, P = .016, (95% CI ‒.025, −.003)] but not vice versa. Depressive symptoms predicted
[β = −.043, P < .001, (95% CI ‒.060, −.026); β = −.029, P < .001, (95% CI ‒.043, −.015)] and were predicted by [β = −.030, P = < .001, (95% CI ‒.047, −.014); β = −.025, P = .003, (95% CI ‒.041, −.009)], a decline in spatial working memory and verbal digit
span, respectively.
Conclusions and Implications
Depressive symptoms may be either a risk factor or prodrome for cognitive decline.
In addition, a decline in attention predicts depressive symptoms. Clinical implications
and implications for further research are discussed.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the American Medical Directors AssociationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The global impact of dementia. An analysis of prevalence, incidence, cost and trends.World Alzheimer Report. Alzheimer Disease International, London2015
- Pharmacological treatment of dementia.Curr Opin Psychiatry. 2012; 25: 542-550
- The Lancet commission on dementia prevention and care.The Lancet. 2017; 390: 2673-2734
- Is depression a risk factor for dementia or cognitive decline? A review.Gerontology. 2000; 46: 219-227
- Recurrent depressive symptoms and the incidence of dementia and mild cognitive impairment.Neurology. 2010; 75: 27-34
- Increased risk of developing dementia in patients with major affective disorders compared to patients with other medical illnesses.J Affect Disord. 2003; 73: 261-269
- Depression and risk for Alzheimer Disease.Arch Gen Psychiatry. 2006; 63: 530
- Temporal relation between depression and cognitive impairment in old age: Prospetive population based study.Br Med J. 2004; 329: 881-883
- Depressive symptoms and cognitive decline in late life.Arch Gen Psychiatry. 2006; 63: 153
- Late life depression, mild cognitive impairment, and dementia: Possible continuum?.Am J Geriatr Psychiatry. 2010; 18: 1-19
- Do severity and duration of depressive symptoms predict cognitive decline in older persons? Results from the Longitudinal Aging Study Amsterdam.Aging Clin Exp Res. 2004; 16: 226-232
- Depression in Alzheimer's disease: Is there a temporal relationship between the onset of depression and the onset of dementia?.Eur Psychiatry. 2002; 17: 254-258
- Depression history, depressive symptoms, and incident dementia: The 3C study.J Alzheimer’s Dis. 2011; 26: 27-38
- Age of major depression onset, depressive symptoms, and risk for subsequent dementia: Results of the German study of Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe).Psychol Med. 2013; 43: 1597-1610
- Trajectories of depressive symptoms before diagnosis of dementia: A 28-year follow-up study.JAMA Psychiatry. 2017; 74: 712-718
- Cognitive tests that best discriminate between presymptomatic AD and those who remain nondemented.Neurology. 2000; 55: 1847-1853
- Online assessment of risk factors for dementia and cognitive funciton in healthy adults.Int J Geriatr Psychiatry. 2018; 33: e286-e293
- The PHQ-9: Validity of a brief depression severity measure.J Gen Intern Med. 2001; 16: 606-613
- Putting brain training to the test.Nature. 2010; 465: 775-778
- Utility, reliability, sensitivity and validity of an online test system designed to monitor changes in cognitive function in clinical trials.Int J Geriatr Psychiatry. 2017; 32: e83-e92
- Computerized delayed matching to sample and paired associate performance in the early detection of dementia.Appl Neuropsychol. 1995; 2: 72-78
- A 3 min reasoning test based on grammatical transformation.Psychon Sci. 1968; 10: 341-342
- Planning and spatial working memory following frontal lobe lesions in man.Neuropsychologia. 1990; 28: 1021-1034
- Neuropsychological Assessment.5th ed. Oxford University Press, Oxford2012
- Lavaan: An R package for structural equation modeling.J Statistical Software. 2012; 48: 1-36
- Does depression precede or follow executive dsyfunction? Outcomes in older primary care patients.Am J Psychiatry. 2007; 164: 1221-1228
- Temporal relationship between depressive symptoms and cognitive impairment: The Italian longitudinal study on aging.J Alzheimer's Dis. 2009; 17: 899-911
- Age-associated cogntive decline.Br Med Bull. 2009; 92: 135-152
- Marital status and risk of Alzheimer's disease: A French population-based cohort study.Neurology. 1999; 53: 1953-1958
- Education and risk of dementia: Dose-response meta-analysis of prospective cohort studies.Mol. Neurobio. 2016; 53: 3113-3123
Article info
Publication history
Published online: March 06, 2020
Footnotes
This article represents independent research funded by the National Institute for Health Research (NIHR) Biomedical Research Center at South London and Maudsley NHS Foundation Trust and King's College London. This research was also supported by the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula and the NIHR Exeter Clinical Research Facility. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health.
The authors declare no conflicts of interest.
Identification
Copyright
© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
